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Severe allergy sufferers advised to avoid Pfizer/BioNTech COVID vaccine but perhaps not forever say experts

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If more cases of allergic reactions do come to light, or a stance by the global medical profession takes a similar path to that now being taken for the flu jab, we could see regulators still encourage people to take the vaccine in time. The Freelance Informer reports.

Yesterday was a momentous day for world health with the UK becoming the first country to administer the Pfizer/BioNTech COVID-19 vaccine to high-risk patients, including a ninety-year-old grandmother. However, on the same day, after two NHS workers had severe allergic reactions to the vaccine, the Medicines and Healthcare products Regulatory Agency has cautioned anyone with severe allergies to food, medicines or vaccines to avoid the vaccine.

The reason this potential side effect was not calculated into the risk profile was because people with severe allergies were not initiated into any of the clinical trials.

According to a BBC report, the two affected workers are understood to have had an anaphylactoid reaction – much milder than anaphylaxis – which tends to involve a skin rash, breathlessness and sometimes a drop in blood pressure. They are both doing fine now, according to the report.

Both NHS workers have a history of serious allergies and carry adrenaline pens around with them.

Professor Stephen Powis, medical director for the NHS in England, said, “As is common with new vaccines, the MHRA have advised on a precautionary basis that people with a significant history of allergic reactions do not receive this vaccination after two people with a history of significant allergic reactions responded adversely.”

Dr June Raine, head of the MHRA, said it was only right to take this step now that “we’ve had this experience”.

Reactions like this are uncommon, but do happen with other vaccines, including the annual flu jab, which has links to egg allergies.

However, in light of the reactions, what can those with severe allergies expect when it comes to protecting themselves and their families from contracting the COVID virus?

Post-jab monitoring

If more cases of reactions do come to light, or a stance by the global medical profession takes a similar path to that now being taken for the flu jab, we could see regulators still encourage people to take the vaccine in time. Here is why.

The CDC and its Advisory Committee on Immunization Practices have not changed their recommendations regarding egg allergy and receipt of influenza (flu) vaccines. The recommendations remain the same as those recommended for the 2018-2019 season, according to the CDC.

In a statement on the CDC web site it reads, “Based on those recommendations, people with egg allergies no longer need to be observed for an allergic reaction for 30 minutes after receiving a flu vaccine. People with a history of egg allergy of any severity should receive any licensed, recommended, and age-appropriate influenza vaccine. Those who have a history of severe allergic reaction to egg (i.e., any symptom other than hives) should be vaccinated in an inpatient or outpatient medical setting (including but not necessarily limited to hospitals, clinics, health departments, and physician offices), under the supervision of a health care provider who is able to recognize and manage severe allergic conditions.”

Over time, we could see a similar post-monitoring approach for those with severe allergies that wish to protect themselves by taking one of the COVID-19 vaccines.

Further investigation and was it expected?

According to Prof Stephen Evans, Professor of Pharmacoepidemiology, London School of Hygiene & Tropical Medicine, allergic reaction occurs with quite a number of vaccines, and perhaps even more frequently with drugs.  “So it is not unexpected,” he said.

“The Pfizer data showed that about 0.6% of people had some form of allergic reaction in the trial on the vaccine, but about 0.5% on placebo.  So there was a genuine excess of allergic reaction but this was small and the true rate is not known, and there is a lot of uncertainty around that estimate.

“The only thing that is contraindicated with this vaccine (meaning you mustn’t have it) is hypersensitivity to the vaccine or any of the excipients (other things in the vaccine), but some people won’t know if they have hypersensitivity to some constituents of the vaccine,” said Evans

Evans suggested that it would be wise, as the MHRA have already advised, for anyone who has known severe allergic reaction such that they need to carry an EpiPen, to delay having a vaccination until the reason for the allergic reaction has been clarified.

“For the general population this does not mean that they would need to be anxious about receiving the vaccination.  One has to remember that even things like marmite can cause unexpected severe allergic reactions,” he said.

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